DAS Total Home Protection policy wording

Transcription

DAS Total Home Protection policy wording
TOTAL HOME
PROTECTION
COMBINED POLICY WORDING
HOME INSURANCE CLAIMS – 0800 107 8166
Should you wish to claim under your home insurance policy, please phone the Household Claims Helpline
on 0800 107 8166 and select the appropriate option for reporting a home insurance claim.
LEGAL EXPENSES AND
EMERGENCY ASSISTANCE
SECTION 1: DAS FAMILY
Claims helpline: 0800 107 8166
Master policy number: TS3/2075877
SECTION 2: HOME EMERGENCY
Emergency helpline: 0800 107 8166
Master policy number: TS3/3520699
SECTION 3: KEY PROTECT
Emergency helpline: 0800 107 8166
2
CONTENTS
HELPLINES
4
WELCOME TO DAS FAMILY AND HOME EMERGENCY
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SECTION 1:
DAS FAMILY
THE MEANING OF WORDS IN THIS SECTION
8
OUR AGREEMENT
10
INSURED INCIDENTS
11
EXCLUSIONS 15
CONDITIONS 16
SECTION 2:
HOME EMERGENCY
THE MEANING OF WORDS IN THIS SECTION
19
COVER
20
INSURED INCIDENTS
21
WHAT IS NOT COVERED
22
CONDITIONS THAT APPLY
23
SECTION 3:
KEY PROTECT
WELCOME TO KEY PROTECT
24
THE MEANING OF WORDS IN THIS SECTION
27
COVER
28
WHAT IS NOT COVERED
29
CONDITIONS THAT APPLY
31
CONSUMER INSURANCE (DISCLOSURE & REPRESENTATIONS) ACT 2012
33
DATA PROTECTION
33
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HELPLINE SERVICES
You can contact our UK-based call centres 24 hours a day, seven days a week. However, we may need to
arrange to call you back depending on your enquiry. To help us check and improve our service standards,
we may record all inbound and outbound calls, except those to the counselling service. When phoning,
please tell us your policy number and the name of the insurance provider who sold you this policy.
LEGAL ADVICE SERVICE
Call 0800 107 8166
We provide confidential advice over the phone on any personal legal issue, under the laws of any
European Union country, the Isle of Man, Channel Islands, Switzerland and Norway.
Advice about the law in England and Wales is available 24 hours a day, seven days a week.
Legal advice for the other countries is available 9am – 5pm, Monday to Friday, excluding public and
bank holidays. If you call outside these times, we will call you back.
TAX ADVICE SERVICE
Call 0800 107 8166
We offer confidential advice over the phone on personal tax matters in the UK.
Tax advice is provided by tax advisors 9am – 5pm, Monday to Friday, excluding public and
bank holidays. If you call outside these times, we will call you back.
HEALTH AND MEDICAL INFORMATION SERVICE
Call 0800 107 8166
We will give you information over the phone on general health issues and advice on a wide variety of
medical matters. We can give you information on all health services including hospital waiting lists.
Health and medical information is provided by qualified nurses 9am – 5pm, Monday to Friday,
excluding public and bank holidays. If you call outside these times, we will call you back.
COUNSELLING SERVICE
Call 0800 107 8166
We will provide you with a confidential counselling service over the phone. This includes, where
appropriate, referral to relevant voluntary or professional services. You will pay any costs for using
the services to which we refer you.
This helpline is open 24 hours a day, seven days a week.
IDENTITY THEFT SERVICE
Call 0800 107 8166
If you are a resident in the UK or the Channel Islands, we will provide you with detailed guidance and
advice over the phone about being or becoming a victim of identity theft.
This helpline is open 8am – 8pm, seven days a week.
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For the following four helpline services, you will be responsible for paying the costs for the help.
DOMESTIC HELP
Call 0800 107 8166
We will arrange for help or repairs needed if you have a domestic emergency in your home, such as
a burst pipe, blocked drain, broken window or building damage.
VETERINARY HELP
Call 0800 107 8166
We can help find a vet who can offer treatment if your pet is ill or injured.
CHILDCARE HELP*
Call 0800 107 8166
We can help you find a range of childcare options in your area if an unforeseen event occurs
(such as illness or injury to you) and you need to make alternative childcare arrangements.
HOME HELP*
Call 0800 107 8166
We can help you find cleaning staff, au pairs and housekeepers if you need assistance to run
your home in a crisis (such as illness or injury to you).
*We can provide you with contract details for these services 24 hours a day seven days a week, but most
of them only work during standard office hours. Outside of these times, we will contact them for you the
next working days and call you back.
We cannot accept responsibility if the Helpline Services are unavailable for reasons we cannot control.
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WELCOME TO DAS FAMILY
AND HOME EMERGENCY
Thank you for taking out a DAS Family and Home Emergency policy. You are now protected by Europe’s
leading legal expenses insurer. To make sure you get the most from your DAS cover, please take time to read
this policy which explains the contract between you and us. If you have any questions or would like more
information, please contact your insurance adviser.
HOW WE CAN HELP
Section 1: DAS Family
To make a claim under this section of your policy, please phone us on 0800 107 8166 and select the
appropriate option for the legal advice helpline. We will ask you about your legal dispute and if necessary
call you back at an agreed time to give you legal advice.
If your dispute needs to be dealt with as a claim under this section of the policy, we will give you a claim
reference number. At this point we will not be able to tell you whether you are covered but we will pass
the information you have given us to our claims-handling teams and explain what to do next.
If you prefer to report your claim in writing, you can send it to our Claims Department at the following address:
Claims Department | DAS Legal Expenses Insurance Company Limited | DAS House | Quay Side |
Temple Back | Bristol | BS1 6NH
Or you can email your claim to us at [email protected]
Section 2: Home Emergency
Before asking for help, please check that the problem is covered by this section of your policy. It is important
that you contact our assistance centre as soon as possible after the home emergency and within 48 hours of
becoming aware of the problem. Our phone lines are open 24 hours a day, 365 days a year. Do not arrange for
a contractor yourself, as we will not pay for this.
To claim under this section of your policy, please phone us on 0800 107 8166, select the appropriate option
for the Home Emergency service, and state:
your name and your home address including postcode;
ƒƒ
the nature of the problem.
ƒƒ
When you have given us details of your claim and we have accepted it, we will arrange for one of our
approved contractors to help you as quickly as possible. We will tell you what to do next.
All phone calls to us are monitored and recorded as part of our training and quality assurance
programmes. By using this service you are agreeing to us recording your call. Please note that remote
locations and bad weather may affect our normal standards of service.
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WHEN WE CANNOT HELP
Section 1: DAS Family
Please do not ask for help from a lawyer, accountant or anyone else before we have agreed. If you do,
we will not pay the costs involved even if we accept the claim.
Section 2: Home Emergency
In a situation that could result in serious risk to you or substantial damage to your home, you should
immediately contact the emergency services (fire, police or ambulance). If there is an emergency relating
to a service such as water or gas, you should also contact any company responsible for supplying
the service.
We will pay a claim only if we have given our agreement and only if there is someone at home when our
approved contractor arrives.
HOW TO MAKE A COMPLAINT
We will always try to give you a quality service. If you think we have let you down, please write to our
Customer Relations Department at our Head Office address:
Our Head and Registered Office:
DAS Legal Expenses Insurance Company Limited | DAS House | Quay Side | Temple Back |
Bristol | BS1 6NH
Registered in England and Wales, number 103274 | Website: www.das.co.uk
Or you can phone us on 0844 893 9013 or email us at [email protected]
Details of our internal complaint-handling procedures are available on request.
If you are still not satisfied and are a small business, you can contact the Insurance Division of the
Financial Ombudsman Service at: Exchange Tower | London | E14 9SR
You can also contact them on: 0800 023 4567 (free from mobile phones and landlines), 0300 123 9123 or email
them at [email protected] | Website: www.financial-ombudsman.org.uk
Your complaint may be more suitably handled by a comparable complaints scheme, the Legal Ombudsman
Service. You can contact the Legal Ombudsman Service at: PO Box 6806 | Wolverhampton | WV1 9WJ
You can also contact them by telephone on 0300 555 0333 or email them at [email protected]
| Website: www.legalombudsman.org.uk
Using this service does not affect your right to take legal action.
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SECTION 1: DAS FAMILY
THE MEANING OF WORDS IN THIS SECTION
The following words have these meanings wherever they appear in this section in bold.
The following definitions apply to this section and shall keep the same meaning wherever they appear
in this section. If there is a conflict between a definition in this section and a definition elsewhere in the
policy, the definition in this section will apply.
appointedThe preferred law firm, law firm, accountant or other suitably qualified person
representative
we will appoint to act on your behalf.
(a)All reasonable and necessary costs chargeable by the appointed
representative and agreed by us in accordance with the DAS Standard
Terms of Appointment.
(b)The costs incurred by opponents in civil cases if you have been ordered
to pay them, or you pay them with our agreement.
costs and expenses
countries covered (a)For insured incidents 2 Contract disputes, and 3 Personal injury:
The European Union, the Isle of Man, the Channel Islands, Albania, Andorra,
Bosnia Herzegovina, Croatia, Gibraltar, Iceland, Liechtenstein, Macedonia,
Monaco, Montenegro, Norway, San Marino, Serbia, Switzerland and Turkey.
(b) For all other insured incidents:
The United Kingdom of Great Britain and Northern Ireland, the Isle of Man
and the Channel Islands.
DAS Standard
The terms and conditions (including the amount we will pay to an appointed
Terms of Appointment representative) that apply to the relevant type of claim, which could include
a conditional fee agreement (no win, no fee). Where a law firm is acting as an
appointed representative the amount is currently £100 per hour. This amount
may vary from time to time.
(a)For civil cases, the date of the event that leads to a claim. If there is
more than one event arising at different times from the same originating
cause, the date of occurrence is the date of the first of these events.
(This is the date the event happened, which may be before the date you
first became aware of it.)
(b)For criminal cases, the date you began, or are alleged to have begun,
to break the law.
(c)For insured incident 6 Tax protection, the date when HM Revenue & Customs
first notifies you in writing of its intention to make an enquiry.
date of occurrence
identity theft
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The theft or unauthorised use of your personal identification which has resulted
in the unlawful use of your identity.
period of insurance
The period for which we have agreed to cover you.
preferred law firm
A law firm or barristers’ chambers we choose to provide legal services.
These legal specialists are chosen as they have the proven expertise to deal
with your claim and must comply with our agreed service standard levels,
which we audit regularly. They are appointed according to the DAS Standard
Terms of Appointment.
reasonable prospectsFor civil cases, the prospects that you will recover losses or damages (or obtain
any other legal remedy that we have agreed to, including an enforcement of
judgment), make a successful defence or make a successful appeal or defence
of an appeal, must be at least 51%. We, or a preferred law firm on our behalf,
will assess whether there are reasonable prospects.
we, us, our, DAS
DAS Legal Expenses Insurance Company Limited.
you, your
The person who has taken out this policy (the policyholder)and any member of
their family who always lives with them. This includes students temporarily living
away from home and unmarried partners.
Anyone claiming under this policy must have the policyholder’s agreement to claim.
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OUR AGREEMENT
We agree to provide the insurance described in section 1, in return for payment of the premium
and subject to the terms, conditions, exclusions and limitations set out in this policy, provided that:
1
2
3
4
reasonable prospects exist for the duration of the claim
the date of occurrence of the insured incident is during the period of insurance
any legal proceedings will be dealt with by a court, or other body which we agree to,
within the countries covered, and
the insured incident happens within the countries covered.
WHAT WE WILL PAY
We will pay an appointed representative, on your behalf, costs and expenses incurred following an
insured incident, provided that:
(a)the most we will pay for all claims resulting from one or more event arising at the same time or from
the same originating cause is £50,000
(b)the most we will pay in costs and expenses is no more than the amount we would have paid to a
preferred law firm. The amount we will pay a law firm (where acting as an appointed representative)
is currently £100 per hour. This amount may vary from time to time.
(c)in respect of an appeal or the defence of an appeal, you must tell us within the time limits allowed
that you want to appeal. Before we pay the costs and expenses for appeals, we must agree that
reasonable prospects exist
(d)for an enforcement of judgment to recover money and interest due to you after a successful claim
under this policy, we must agree that reasonable prospects exist, and
(e)where an award of damages is the only legal remedy to a dispute and the cost of pursuing legal
action is likely to be more than any award of damages, the most we will pay in costs and expenses
is the value of the likely award.
WHAT WE WILL NOT PAY
(a)In the event of a claim, if you decide not to use the services of a preferred law firm, you will be
responsible for any costs that fall outside the DAS Standard Terms of Appointment and these will
not be paid by us.
(b)The first £250 of any claim for legal nuisance or trespass. You must pay this as soon as we accept
the claim.
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INSURED INCIDENTS
For advice or to make a claim call 0800 107 8166
What is covered
Please also refer to our agreement on page 10.
1 EMPLOYMENT DISPUTES
A dispute relating to your contract of employment
or future employment.
2 CONTRACT DISPUTES
A dispute arising from an agreement or an alleged
agreement which you have entered into in a personal
capacity for:
(a) buying or hiring in goods or services.
(b) selling goods.
Please note that:
(i) you must have entered into the agreement or
alleged agreement during the period of insurance,
and
(ii) the amount in dispute must be more than £100.
3 PERSONAL INJURY
A specific or sudden accident that causes your death
or bodily injury to you.
4 CLINICAL NEGLIGENCE
An identified negligent act of surgery or
identified negligent clinical or medical procedure,
which causes death or bodily injury to you.
What is not covered
Please also refer to section 1 exclusions on page 15.
A claim relating to the following:
(a) employer’s disciplinary hearings or internal
grievance procedures
(b) any claim relating solely to personal injury
(c)a compromise agreement while you are
still employed.
A claim relating to the following:
(a) construction work on any land, or designing,
converting or extending any building where the
contract value exceeds £5,000 (including VAT)
(b) the settlement payable under an insurance policy
(we will cover a dispute if your insurer refuses
your claim, but not for a dispute over the amount
of the claim)
(c) a dispute arising from any loan, mortgage, pension,
investment or borrowing
(d) a dispute over the sale, purchase, terms of a lease,
licence, or tenancy of land or buildings. However,
we will cover a dispute with a professional adviser
in connection with these matters.
A claim relating to the following:
(a) illness or bodily injury that happens gradually
(b) psychological injury or mental illness unless the
condition follows a specific or sudden accident that
has caused physical bodily injury to you
(c)defending your legal rights, but we will cover
defending a counter-claim
(d) clinical negligence.
A claim relating to the following:
(a) the failure or alleged failure to correctly diagnose
your condition
(b) psychological injury or mental illness that is not
associated with you having suffered physical
bodily injury.
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For advice or to make a claim call 0800 107 8166
What is covered
Please also refer to our agreement on page 10.
5 PROPERTY PROTECTION
A civil dispute relating to property you own, or
are responsible for (including your main and holiday
home) following:
(a)an event which causes physical damage to such
property but the amount in dispute must be more
than £100
(b)a legal nuisance (meaning any unlawful
interference with your use or enjoyment of your
land, or some right over, or in connection with it)
(c)a trespass.
lease note that you must have established the
P
legal ownership or right to the land that is the subject
of the dispute.
6 TAX PROTECTION
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A comprehensive examination by HM Revenue
& Customs that considers all areas of your self
assessment tax return, but not enquiries limited to
one or more specific area.
What is not covered
Please also refer to section 1 exclusions on page 15.
(a) A claim relating to the following:
(i) a contract you have entered into
(ii)any building or land except your main
or holiday home
(iii)someone legally taking your property from
you, whether you are offered money or
not, or restrictions or controls placed on
your property by any government or public
or local authority
(iv)work done by, or on behalf of, any
government or public or local authority
unless the claim is for accidental
physical damage
(v) mining subsidence
(vi)adverse possession (meaning the
occupation of any building or land either
by someone trying to take possession
from you or of which you are trying to
take possession)
(vii)the enforcement of a covenant by or
against you.
(b) Defending a claim relating to an event that
causes physical damage to property, but we will
cover defending a counter-claim.
(c) The first £250 of any claim for legal nuisance
or trespass. If you are using a preferred law firm,
you will be asked to pay this within 21 days of your
claim having been assessed as having reasonable
prospects. If you are using your own law firm,
this will be within 21 days of their appointment
(following confirmation your claim has reasonable
prospects). If you do not pay this amount the cover
for your claim could be withdrawn
(a)Any claim if you are self-employed, or a sole trader,
or in a business partnership.
(b)An investigation or enquiries by HM Revenue
& Customs Specialist Investigations or the
HM Revenue & Customs Prosecution Office.
For advice or to make a claim call 0800 107 8166
What is covered
Please also refer to our agreement on page 10.
7 JURY SERVICE AND COURT ATTENDANCE
Your absence from work:
What is not covered
Please also refer to section 1 exclusions on page 15.
Any claim if you are unable to prove your loss.
(a)to attend any court or tribunal at the request
of the appointed representative
(b) to perform jury service
(c)to carry out activities specified in your identity
theft action plan under insured incident
9 Identity theft.
The maximum we will pay is your net salary or
wages for the time that you are absent from work
less any amount the court gives you.
8 LEGAL DEFENCE
Costs and expenses to defend your legal rights:
A claim relating to the following:
(a)parking or obstruction offences
(b)you driving a motor vehicle that you do not have
valid motor insurance for.
(a)if an event arising from your work as an employee
leads to
(i)
you being prosecuted in a court of
criminal jurisdiction
(ii)civil action being taken against you under:
 discrimination legislation
 section 13 of the Data Protection Act 1998
(b)if an event leads to you being prosecuted for
an offence connected with the use or driving of
a motor vehicle.
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For advice or to make a claim call 0800 107 8166
What is covered
Please also refer to our agreement on page 10.
What is not covered
Please also refer to section 1 exclusions on page 15.
9 IDENTITY THEFT PROTECTION
(1)Following a call to the identity theft helpline
service we will assign a personal caseworker
who will provide phone advice and a personal
action plan to help regain your identity.
(2)If you become a victim of identity theft, we will
pay the costs you incur for phone calls, faxes or
postage to communicate with the police, credit
agencies, financial service providers, other
creditors or debt-collection agencies. We will
also pay the cost of replacement documents to
help restore your identity and credit status.
(3)Following your identity theft we will pay:
(a)legal costs to reinstate your identity including
costs for the signing of statutory declarations
or similar documents
(b)legal costs to defend your legal rights in a
dispute with debt collectors or any party
taking legal action against you arising from
or relating to identity theft
(c)loan-rejection fees and any re-application
administration fee for a loan when your
original application has been rejected.
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Please note that:
(i) you must notify your bank or building society
as soon as possible
(ii) you must tell us if you have previously
suffered identity theft, and
(iii) you must take all reasonable action to prevent
continued unauthorised use of your identity.
A claim relating to the following:
(a)fraud committed by anyone entitled to make a claim
under this policy
(b)losses arising from your business activities.
EXCLUSIONS
We will not pay for the following:
1 Late reported claims
A claim where you have failed to notify us of the insured incident within a reasonable time
of it happening and where this failure adversely affects the reasonable prospects of a claim
or we consider our position has been prejudiced.
2
osts we have not agreed
C
Costs and expenses incurred before our written acceptance of a claim.
3
Court awards and fines
Fines, penalties, compensation or damages that a court or other authority orders you to pay.
4 Legal action we have not agreed
Any legal action you take that we or the appointed representative have not agreed to, or where
you do anything that hinders us or the appointed representative.
5 Group litigation order
Any claim where you may be one of a number of people involved in a legal action resulting from
one or more events arising at the same time or from the same cause which could result in the court
making a Group Litigation Order.
6
Defamation
Any claim relating to written or verbal remarks that damage your reputation.
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A dispute with DAS
A dispute with us not otherwise dealt with under policy condition 8.
8 Judicial review
Costs and expenses arising from or relating to judicial review, coroner’s inquest or fatal
accident inquiry.
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Nuclear, war and terrorism risks
A claim caused by, contributed to by or arising from:
(a)ionising radiation or contamination by radioactivity from any nuclear fuel or from any nuclear
waste from burning nuclear fuel
(b)the radioactive, toxic, explosive or other hazardous properties of any explosive nuclear
assembly or nuclear part of it
(c)war, invasion, foreign enemy hostilities (whether war is declared or not), civil war, rebellion,
revolution, military force or coup, or any other act of terrorism or alleged act of terrorism as
defined in the Terrorism Act 2000
(d)pressure waves caused by aircraft or any other airborne devices travelling at sonic or
supersonic speeds.
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CONDITIONS
1
Your legal representation
(a)On receiving a claim, if legal representation is necessary, we will appoint a preferred law firm
as your appointed representative to deal with your claim. They will try to settle your claim by
negotiation without having to go to court.
(b)If the appointed preferred law firm cannot negotiate settlement of your claim and it is necessary
to go to court and legal proceedings are issued or there is a conflict of interest, then you may
choose a law firm to act as the appointed representative.
(c)If you choose a law firm as your appointed representative who is not a preferred law firm, we
will give your choice of law firm the opportunity to act on the same terms as a preferred law
firm. However if they refuse to act on this basis, the most we will pay is the amount we would
have paid if they had agreed to the DAS Standard Terms of Appointment. The amount we will pay
a law firm (where acting as the appointed representative) is currently £100 per hour. This amount
may vary from time to time.
(d)The appointed representative must co-operate with us at all times and must keep us up to date
with the progress of the claim.
2 Your responsibilities
(a) You must co-operate fully with us and the appointed representative.
(b) You must give the appointed representative any instructions that we ask you to.
3
Offers to settle a claim
(a)
You must tell us if anyone offers to settle a claim. You must not negotiate or agree to a settlement
without our written consent.
(b)If you do not accept a reasonable offer to settle a claim, we may refuse to pay further legal costs.
(c)
We may decide to pay you the reasonable value of your claim, instead of starting or continuing
legal action. In these circumstances you must allow us to take over and pursue or settle any claim
in your name. You must also allow us to pursue at our own expense and for our own benefit, any
claim for compensation against any other person and you must give us all the information and help
we need to do so.
4 Assessing and recovering costs
(a)
You must instruct the appointed representative to have legal costs taxed, assessed or audited
if we ask for this.
(b)
You must take every step to recover costs and expenses and court attendance and jury service
expenses that we have to pay and must pay us any amounts that are recovered.
5 Cancelling an appointed representative’s appointment
If the appointed representative refuses to continue acting for you with good reason, or if you dismiss
the appointed representative without good reason, the cover we provide will end immediately, unless
we agree to appoint another appointed representative.
6 Withdrawing cover
If you settle or withdraw a claim without our agreement, or do not give suitable instructions to the
appointed representative, we can withdraw cover and will be entitled to reclaim from you any costs
and expenses we have paid.
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7 Expert opinion
We may require you to get, at your own expense, an opinion from an expert, that we consider
appropriate, on the merits of the claim or proceedings, or on a legal principle. The expert must
be approved in advance by us and the cost agreed in writing between you and us. Subject to this
we will pay the cost of getting the opinion if the expert’s opinion indicates that it is more likely
than not that you will recover damages (or obtain any other legal remedy that we have agreed to)
or make a successful defence.
8 Arbitration
If there is a disagreement between you and us about the handling of a claim and it is not resolved
through our internal complaints procedure, you can contact the Financial Ombudsman Service
for help. Alternatively there is a separate arbitration process. The arbitrator will be a barrister
chosen jointly by you and us. If there is a disagreement over the choice of arbitrator, we will ask
the Chartered Institute of Arbitrators to decide.
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Keeping to the policy terms
You must:
(a) keep to the terms and conditions of this policy
(b) take reasonable steps to avoid and prevent claims
(c) take reasonable steps to avoid incurring unnecessary costs
(d) send everything we ask for, in writing, and
(e)report to us full and factual details of any claim as soon as possible and give us any information
we need.
10 Cancelling the policy
You can cancel this policy by telling us within 14 days of taking it out or at any time afterwards as long
as you tell us at least 14 days beforehand. We can cancel this policy at any time as long as we tell you
at least 14 days beforehand.
Subject to the terms of business between you and the person who sold you this policy, you may be
entitled to a partial refund of the premium.
It is important to note that charges may apply to any refund subject to the individual terms of
business between you and the person who sold you this policy. Please contact them directly for full
details of charges.
11 Fraudulent claims
We will, at our discretion, void the policy (make it invalid) from the date of claim, or alleged claim,
or we will not pay the claim if:
(a)a claim you have made to obtain benefit under this policy is fraudulent or intentionally
exaggerated, or
(b)a false declaration or statement is made in support of a claim.
Where the above circumstances apply, as part of our fraud prevention measures we will, at our
discretion, also share information with other parties such as the police, government bodies and
anti-fraud organisations.
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12 Claims under this policy by a third party
Apart from us, you are the only person who may enforce all or any part of this policy and the rights
and interests arising from or connected with it. This means that the Contracts (Rights of Third Parties)
Act 1999 does not apply to the policy in relation to any third-party rights or interest.
13 Other insurances
If any claim covered under this policy is also covered by another policy, or would have been
covered if this policy did not exist, we will only pay our share of the claim even if the other insurer
refuses the claim.
14 Law that applies
This policy is governed by the law that applies in the part of the United Kingdom, Channel Islands or
Isle of Man where you normally live. Otherwise, the law of England and Wales applies.
All Acts of Parliament mentioned in this policy include equivalent laws in Scotland, Northern Ireland,
the Isle of Man and the Channel Islands as appropriate.
Andrew Burke
Chief Executive Officer, DAS Group
DAS Head and Registered Office:
DAS Legal Expenses Insurance Company Limited | DAS House | Quay Side | Temple Back | Bristol | BS1 6NH
Registered in England and Wales | number 103274 | Website: www.das.co.uk
DAS Legal Expenses Insurance Company Limited is authorised by the Prudential Regulation Authority and
regulated by the Financial Conduct Authority and the Prudential Regulation Authority.
Financial Services Compensation Scheme
We are covered by the Financial Services Compensation Scheme (FSCS). Compensation from the scheme
may be claimed if we cannot meet our obligations. This will be dependent on the type of business and the
circumstances of the claim. More information on the compensation scheme arrangements can be found on
the FSCS website, www.fscs.org.uk
DAS Law Limited Head and Registered Office:
DAS Law Limited | North Quay | Temple Back | Bristol | BS1 6FL
Registered in England and Wales | number 5417859 | Website: www.daslaw.co.uk
DAS Law Limited is authorised and regulated by the Solicitors Regulation Authority (registered number 423113).
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SECTION 2: HOME EMERGENCY
THE MEANING OF WORDS IN THIS SECTION
Wherever they appear in this section, the following terms have specific meanings given below.
The following definitions apply to this section and shall keep the same meaning wherever they appear
in this section. If there is a conflict between a definition in this section and a definition elsewhere in the
policy, the definition in this section will apply.
homeYour main home (having no more than 15 rooms) situated in the United Kingdom
of Great Britain and Northern Ireland, the Isle of Man or the Channel Islands.
insured person/people You and any person who lives in or is staying at your home.
main heating system
The main hot-water or central-heating system in your home. This includes pipes
that connect components of the system but not cold-water supply or drainage
pipes. It does not include any non-domestic heating or non-domestic hot-water
systems or any form of solar heating.
period of cover
The period for which we have agreed to cover you.
plumbing and drainage The cold-water supply and drainage system within the boundary of your home
and for which you are legally responsible. This does not include:
(a) pipes for which your water supply or sewerage company are responsible;
(b) rainwater drains and soakaways.
vermin
Wasps’ and/or hornets’ nests, rats, mice; or grey squirrels.
we, us, our
DAS Legal Expenses Insurance Company Limited.
you, your
The person who has taken out this policy.
19
COVER
(a)This section of your policy covers you for insured incidents that are sudden, unexpected, and require
immediate corrective action to:
(i) prevent damage or further damage to your home;
(ii)make your home safe or secure; or
(iii) relieve unreasonable discomfort, risk or difficulty to an insured person.
(b)
Your policy covers you only if you have paid your premium. We agree to provide the insurance in this
section of this policy, subject to its terms, conditions and exclusions, as long as the insured incident
happens during the period of cover.
(c)
We will pay up to £1,000 (including VAT) for the call-out charge, labour costs, parts and materials
to provide help with an insured incident.
(d)If your home remains uninhabitable overnight following an insured incident, we will pay up to £250
for hotel accommodation on a room-only basis for insured people.
(e)If this section of the policy does not cover the service you need, we will try (if you wish) to arrange
it at your expense. The terms of such a service are a matter for you and your supplier.
20
INSURED INCIDENTS
1
OOF DAMAGE
R
Any damage to the roof of your home where internal damage has been caused or is likely.
2
LUMBING AND DRAINAGE
P
The sudden damage to, or blockage, breakage or flooding of, the drains or plumbing system
in your home.
3 MAIN HEATING SYSTEM
Sudden failure to function of the main heating system in your home.
4 DOMESTIC POWER SUPPLY
The failure of your home’s domestic electricity, or domestic gas supply, but not the failure
of the mains supply.
5 TOILET UNIT
Impact damage to, or mechanical failure of, a toilet bowl or cistern that results in complete loss
of function of the only or of all toilets in your home.
6 HOME SECURITY
Damage to, or the failure of, external doors, windows or locks which leaves your home insecure.
7 LOST KEYS
The loss of the only available set of keys to your home if you cannot replace them, or gain
normal access.
8 VERMIN
The sudden infestation by vermin in your home which prevents the use of the loft or one or more
rooms in your home.
Damage caused by vermin outside the main dwelling e.g. in garages and other outbuildings,
is not covered.
21
WHAT IS NOT COVERED
1 A claim following an insured incident which happens during the first 48 hours from the start of your
period of cover if you take out this policy at a different time from any other related agreement.
2 An incident or matter arising before the start of this policy.
3 A claim where your home has been left unoccupied for 30 consecutive days.
4 A claim where we have given instructions relating to the help we are providing and the insured
person has not followed them.
5 Costs incurred where our approved contractor has attended but your home was unoccupied.
6 Costs incurred before an insured person has notified us of an insured incident.
7 A claim arising from a deliberate act or omission by an insured person.
8 A property that you rent or let or that you own that is not your main residence.
9 Normal day-to-day home maintenance that an insured person should carry out or pay for (such as
servicing of heating and hot-water systems) and the replacement of parts that tend to gradually wear
out or need regular attention.
10A claim for parts or labour if the equipment or facility is still under guarantee or warranty from the
maker, supplier or installer.
11A claim relating to the failure of equipment or facilities that results from them being incorrectly
installed, repaired, modified or maintained, or that is caused by a design fault that makes them
inadequate or unfit for use.
12 Damage caused gaining necessary access to, or in reinstating the fabric of, your home.
13A claim relating to the interruption, failure or disconnection of the mains electricity, mains gas
or mains water supply, or an insured person’s failure to buy or provide enough gas, electricity
or other fuel source.
14Damage to boundary walls, gates, hedges, fences or outbuildings and damage that only affects
garages except where the garage is incorporated within your home sharing a single roof and an
adjoining wall.
15 The malfunction or blockage of septic tanks, cess pits or fuel tanks.
16 A claim arising from subsidence, landslip or heave.
17 Homes with more than 15 rooms.
22
CONDITIONS THAT APPLY
1 Claims must be reported to us as soon as possible and no later than 48 hours after you first become
aware of the insured incident.
2 An insured person must:
(a) keep to the terms and conditions of this policy;
(b) maintain the home in a reasonable condition, carry out any inspections or services of fittings
in accordance with the manufacturer’s instructions and complete any necessary maintenance
to the structure of the home;
(c) try to prevent anything happening that may cause a claim;
(d) take reasonable steps to keep any amount we have to pay as low as possible.
3 You can cancel this policy by telling us within 14 days of taking it out; or at any time afterwards
as long as you tell us at least 14 days beforehand. We can cancel this policy at any time as long
as we tell you at least 14 days beforehand.
Subject to the terms of business between you and the person who sold you this policy, you may be
entitled to a partial refund of the premium.
It is important to note that charges may apply to any refund subject to the individual terms of
business between you and the person who sold you this policy. Please contact them directly for full
details of charges.
4 We will make every effort to provide the service at all times, but we will not be responsible for any
liability arising from a breakdown of the service for reasons we cannot control.
5 We will not pay for losses that are not directly covered by this policy. For example, we will not pay to
replace a carpet damaged by a leak or for time taken off work because of an insured incident.
6 We will not pay a claim covered under another policy. We will not pay a claim that would have been
covered by another policy if this policy did not exist.
7 This section of the policy will be governed by English law.
8 We will, at our discretion, void the policy (make it invalid) from the date of claim, or alleged claim,
and or we will not pay the claim if:
(a) a claim the insured person has made to obtain benefit under this policy is fraudulent or
intentionally exaggerated, or
(b) a false declaration or statement is made in support of a claim.
Where the above circumstances apply, as part of our fraud prevention measures we will, at our
discretion, also share information with other parties such as the police government bodies and
anti-fraud organisations.
23
SECTION 3: KEY PROTECT
WELCOME TO KEY PROTECT
This policy has been arranged by Motorplus Limited and Qdos Broker & Underwriting Services Limited
and is underwritten by UK General Insurance Limited on behalf of: Ageas Insurance Limited |
Registered in England No. 354568 | Registered office: Ageas House | Hampshire Corporate Park |
Templars Way | Eastleigh | Hampshire | SO53 3YA.
Motorplus Limited, Qdos Broker & Underwriting Services Limited and UK General Insurance Limited are
authorised and regulated by the Financial Conduct Authority.
Ageas Insurance Limited is authorised by the Prudential Regulation Authority and regulated by
the Financial Conduct Authority and the Prudential Regulation Authority. This can be checked on the
Financial Services Register at www.fca.org.uk/register or by contacting them on 0800 111 6768.
Unless expressly stated nothing in this policy will create rights pursuant to the Contracts
(Rights of Third Parties) Act 1999.
IMPORTANT INFORMATION
This is Your Key Protection policy. Please spend some time reading through the policy to ensure that it
meets Your requirements. If there is anything You do not understand, please contact Us. We will be happy
to assist.
This is a contract of insurance between You and Ageas Insurance Limited. The insurance provided covers
certain costs and expenses, subject to the terms, Limit of Indemnity, exclusions and conditions contained
herein, in respect of an Insured Event which occurs within the Territorial Limits and during the Period of
Insurance for which You have paid or agreed to pay the premium.
DEMANDS AND NEEDS
This policy will meet the demands and needs of customers who want to safeguard their keys from loss
or damage. It will provide up to £1,500 annual cover for locksmiths’ charges, new locks and keys, car hire
and onward transport costs. The reprogramming of immobilisers, infra-red handsets and alarms is also
covered. Motorplus Limited do not make any personal recommendations as to whether this policy will
suit Your individual circumstances.
24
CANCELLATION RIGHT
If You decide that for any reason that this policy does not meet Your insurance needs, then please return
it to the insurance broker or agent who provided this policy to You within 14 days of issue. On the condition
that no claims have been made or are pending, We will then refund Your premium in full. If You wish to
cancel Your policy after 14 days You will not be entitled to a refund.
The Insurer shall not be bound to accept renewal of any insurance and may at any time cancel any
insurance document by giving 30 days notice in writing where there is a valid reason for doing so.
A cancellation letter will be sent to You at Your last known address. Valid reasons may include but are
not limited to:
(a)Fraud
(b) Non-payment of premium
(c) Threatening and abusive behaviour
(d) Non-compliance with policy terms and conditions
Provided the premium has been paid in full You will be entitled to a proportionate rebate of premium in
respect of the unexpired period showing on the insurance.
MAKING A CLAIM
To make a claim call 0333 241 9574, select the Key Protect option and quote the Fob number. You must
report any claim to the Coverholder within 30 days of the Insured Event.
COMPLAINTS PROCEDURE
It is the intention to give You the best possible service but if You do have any questions or concerns about
this insurance or the handling of a claim You should in the first instance contact the Quality Assurance
Manager of Motorplus Limited at the following address: Motorplus Limited | Kircam House | Whiffler Road |
Norwich | NR3 2AL | Tel: 0333 241 9580 | Fax: 01603 420010
Please ensure Your Fob number is quoted in all correspondence to assist a quick and efficient response.
If it is not possible to reach an agreement, You have the right to make an appeal to the Financial
Ombudsman Service. This also applies if You are insured in a business capacity and have an annual
turnover of less than €2 million and fewer than ten staff.
25
You may contact the Financial Ombudsman Service (FOS) at: Financial Ombudsman Service |
Exchange Tower | London | E14 9SR
You can also contact them on: 0800 023 4567 (free from mobile phones and landlines), 0300 123 9123 or email
them at [email protected] | Website: www.financial-ombudsman.org.uk
The above complaints procedure is in addition to Your statutory rights as a consumer. For further
information about Your statutory rights contact Your local authority trading standards service or Citizens
Advice Bureau.
COMPENSATION SCHEME
Ageas Insurance Limited is covered by the Financial Services Compensation Scheme. You may be entitled
to compensation from the scheme in the event that Ageas Insurance Limited cannot meet their obligations.
This depends on the type of business and the circumstances of the claim. Most insurance contracts are
covered for 90% of the claim with no upper limit. You can obtain further information about compensation
scheme arrangements from the FSCS by visiting www.fscs.org.uk
26
THE MEANING OF WORDS IN THIS SECTION
The following definitions apply to this section and shall keep the same meaning wherever they appear
in this section. If there is a conflict between a definition in this section and a definition elsewhere in the
policy, the definition in this section will apply.
Coverholder/We/Us/OurMotorplus Limited and associated and/or subsidiary companies.
Fob
The numbered tag issued to the Policyholder by the Coverholder which
the Coverholder has registered in the Policyholder’s name.
Insured Event
The loss or theft of, or damage to, any Insured Key.
Insured Key
Any key which is attached to the Fob.
Insurer
UK General Insurance Limited on behalf of Ageas Insurance Limited. UK
General Insurance Limited are an Insurers’ agent and in the matters of a
claim act on behalf of the Insurer.
Limit of Indemnity£1,500 being the maximum amount payable in aggregate in each
Period of Insurance.
Period of Insurance
12 months from the date of inception of this policy.
Policyholder
The person in whose name the Coverholder has registered the Fob.
Territorial Limits
The United Kingdom.
Underwriters
UK Underwriting Limited on behalf of Ageas Insurance Limited.
UK Underwriting Limited are an Insurers’ agent and in the matters
of a claim act on behalf of the Insurers.
You/YourThe Policyholder and any immediate member of their family residing at
the same address as the Policyholder during the Period of Insurance.
27
COVER
If during Period of Insurance and within the Territorial Limits an Insured Key is lost, damaged or stolen,
the Coverholder will:
1
ay up to £1,500 in respect of locksmiths charges, new locks (if a security risk has arisen) and
P
replacement keys (including any immobiliser, infra-red handset and/or alarm which is integral to any
Insured Key if such cannot be repaired or re-programmed), car hire and onward transport costs
and the re-programming of immobilisers, infra-red handsets and alarms which are attached to the Fob
but are not integral to an Insured Key.
2
Pay a £10 reward payable to the finder of a lost Insured Key.
3
Provide an Emergency Helpline 24 hours a day, 365 days a year.
28
WHAT IS NOT COVERED
The Insurer/Coverholder will not indemnify You in respect of:
1
Keys lost, stolen or damaged when such keys are not attached to the Fob (unless You have already
notified the Coverholder that the Fob has been lost or damaged and You are awaiting a replacement,
in which event the Coverholder will consider a claim in respect of any key which they are satisfied
would otherwise have been attached to the Fob).
2
Any amount exceeding £1,500 in aggregate in the same Period of Insurance.
3
Sums claimed where You do not produce receipts or invoices for payments You have made.
4
I nsured Keys which are lost until 5 days have elapsed since the loss (unless the Coverholder is
satisfied that a delay would cause undue hardship or significant expense).
5
Insured Keys lost or broken by, or stolen from, someone other than You.
6
Insured Keys if there are duplicate keys available to You.
7
Any Insured Event not reported to the Coverholder within 30 days of the loss, theft or damage.
8
Locks which are damaged prior to the loss or theft of keys.
9
Replacement locks or keys of a higher standard or specification than those replaced.
10 S
ums exceeding £50 per incident in respect of any Insured Key locked inside property or broken in
lock or ignition.
11 Vehicle hire charges where a hire vehicle exceeds 1600cc.
12 The balance of vehicle hire charges over a maximum sum of £40 per day.
13 Vehicle hire charges after the third day of hire.
14 C
harges or costs incurred where the Coverholder arranges for the attendance of a locksmith or other
tradesman, agent or representative at a particular location and You fail to attend.
15 C
harges or costs incurred where You make alternative arrangements with a third party once the
Coverholder has arranged for a locksmith or other tradesman, agent or representative to attend a
particular location.
16 The balance of transport costs over a maximum sum of £75 per day.
17 L oss or destruction of, or damage to, any property other than an Insured Key and its associated lock
or ignition system, and any immobiliser, infra-red handset and/or alarm attached to the Fob.
29
18 L oss or damage caused by radiation, radioactive contamination or the hazardous properties of any
explosive, corrosive, invasive or toxic substance or material.
19 L oss or damage caused by war, invasion, foreign enemy hostilities (whether war is declared or
not), civil war, terrorism, rebellion, revolution, military force or coup, or the actions of any lawful
government or public or local authority.
20 A
ny loss of earnings or profits which You suffer as a result of the loss or theft of, or damage to an
Insured Key.
21 Claims arising from any deliberate or criminal act or omission by You.
22 Loss or theft of, or damage to an Insured Key which occurs outside the Period of Insurance.
23 C
laims arising as a result of Your failure to take steps to safeguard an Insured Key
(for example, by leaving an Insured Key in a lock or ignition in an accessible place).
30
CONDITIONS THAT APPLY
1
ompliance and Precautions
C
You must comply with each and every term of this policy and must ensure that the cost of any claim
is kept to a minimum.
2
ancellation
C
If You decide that for any reason that this policy does not meet Your insurance needs, then please
return it to the insurance broker or agent who provided this policy to You within 14 days of issue.
On the condition that no claims have been made or are pending, We will then refund Your premium in
full. If You wish to cancel Your policy after 14 days You will not be entitled to a refund.
The Insurer shall not be bound to accept renewal of any insurance and may at any time cancel any
insurance document by giving 30 days notice in writing where there is a valid reason for doing so.
A cancellation letter will be sent to You at Your last known address. Valid reasons may include but are
not limited to:
(a)Fraud;
(b) Non-payment of premium;
(c) Threatening and abusive behaviour;
(d) Non-compliance with policy terms and conditions
Provided the premium has been paid in full You will be entitled to a proportionate rebate of premium in
respect of the unexpired period showing on the insurance.
3
Terminology
The terminology used in this policy is that of England and Wales but shall, where appropriate, mean
the equivalent terminology of any relevant jurisdiction within the Territorial Limits.
4
Communications
All communications from the Insurer or their representatives shall be deemed duly sent if sent by
the Coverholder or their representatives to the last known address of the Policyholder, or the address
of their representatives if relevant. All communications by the Policyholder to the Insurer or their
representatives shall be deemed duly sent if sent to the Coverholder.
5
resentation of Claims by the Policyholder
P
The Policyholder must notify the Coverholder as soon as reasonably possible of any
Insured Event which may give rise to a claim, complete any forms requested by the Coverholder
and promptly supply such information as the Coverholder or their agents require.
6
rbitration
A
If there is a dispute between the Coverholder and the Policyholder, which is not resolved by this policy,
either side may refer to the arbitration of a single arbitrator, being a solicitor or barrister agreed by the
two sides. If no agreement can be reached the President of the relevant national Law Society shall
name an arbitrator. The arbitrator’s decision will be final and binding on both sides. The arbitration will
be governed by the rules set out in the Arbitration Acts in force at the time. The costs of arbitration shall
be borne by the instigating party unless deemed otherwise by the arbitrator.
7
ssignment
A
This policy may not be assigned in whole or in part without the written consent of the Coverholder.
31
8
Excess
No excess is payable.
9
aximum Number of Claims
M
There is no limit to the number of separate claims which You may make within the Period
of Insurance subject to the fact that the total aggregate sum which the Coverholder will pay in each
Period of Insurance is £1,500.
10 G
overning Law
Unless some other law is agreed in writing, this policy is governed by English law. If there is a dispute,
it will only be dealt with in the courts of England or of the country within the United Kingdom in which
Your main residence is situated.
11 Fraudulent Claims
If You make any request for a payment under this policy knowing it to be fraudulent or false in any
respect or ought reasonably in the circumstances to have known it to be fraudulent or false or where
there is collusion between any parties to the dispute, this policy shall become void and any premiums
paid hereunder shall be forfeited and We shall be entitled to recover any monies previously paid.
In the event that We suspect that any claim is fraudulent or false or We suspect there is any collusion
between any parties, We may contact and access information held by the Insurance Fraud Bureau
or other fraud prevention agencies to determine if fraud has been reported before, if this has been
investigated and if fraud was detected. If the Insurance Fraud Bureau confirm that You have been
involved in insurance fraud, this policy shall become void and any premiums paid hereunder shall be
forfeited and We shall be entitled to recover any monies previously paid.
32
CONSUMER INSURANCE (DISCLOSURE &
REPRESENTATIONS) ACT 2012
You are required by the provisions of the Consumer Insurance (Disclosure and Representations) Act
2012 to take care to supply accurate and complete answers to all questions and to make sure that all
information supplied to Us is true and correct. You must tell Us of any changes to the answers You have
given as soon as possible. Failure to advise Us of a change to Your answers may mean that Your policy
is invalid and that it does not operate in the event of a claim.
You must contact Us immediately in the event that there is a change to Your circumstances, as follows:



You change Your address;
You are convicted of a criminal offence or receive a police caution;
You have insurance refused, declined, cancelled or terms applied by another insurance provider.
DATA PROTECTION
Please note that any information provided to Us will be processed by Us and Our agents in compliance with
the provisions of the Data Protection Act 1998, for the purpose of providing insurance and handling claims,
if any, which may necessitate providing such information to third parties. We may also send the information
in confidence for process to other companies acting on their instructions including those located outside
the European Economic Area, some of which may not have equivalent Data Protection laws.
We may obtain information about You from credit reference agencies, fraud prevention agencies and
similar organisations to enable Us to check Your credit status and identity. These agencies will record
Our enquiries, which may be seen by other companies who make their own credit enquiries. We may also
check Your details with fraud prevention agencies. If You provide false or inaccurate information and We
suspect fraud, We will record Our concerns. We and other organisations may use these records to help
make decisions on insurance proposals and claims, prevent fraud, recover debt and check Your identity
to prevent money laundering. Under Data Protection legislation, You can ask Us in writing for a copy of
certain personal records held about You. A charge of £10 will be made.
Motorplus Limited are authorised and regulated by the Financial Conduct Authority.
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Wesleyan Household Combined Wording |
06.2016 | DAS 11224.05
Agent’s address